| NPI | 1972652683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IA 415) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 00112) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2019-12-19 |